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Endometrial cancer: integrating molecular insights into personalized care

Published on October 30, 2025   30 min

Other Talks in the Series: Periodic Reports: Advances in Clinical Interventions and Research Platforms

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0:00
My name is Dr. Gemma Eminowicz. I'm a consultant clinical oncologist at University College London Hospital in the UK, treating gynecological cancers. I'm going to talk about endometrial cancer and integrating molecular insights into personalized care.
0:17
As an overview, I'm going to talk about the background, molecular classification in endometrial cancer, and then talk specifically about molecular classification as a prognostic marker, as a predictive marker for treatment response, and how to integrate that into clinical practice. Then I'll briefly touch on potential future pathways.
0:37
Background and molecular classification in endometrial cancer.
0:42
Endometrial cancer is rising in incidence and mortality. We know that approximately three-quarters of the patients, so the majority of patients, do present with stage I or II disease. This is early-stage disease and has an excellent prognosis. However, there are patients who have high intermediate risk, when they have high-grade disease or deep myoinvasion or substantial lymphovascular space invasion, and they still have a 15-25% recurrence rate. High-risk patients, however, who have very high-grade disease or stage III disease can have a 40-60% recurrence rate at five years. We know that relapsed and late-stage disease only have a five-year survival rate of about 17%.
1:25
Talking about the treatment for recurrent or metastatic endometrial cancer, the options have been very limited until recently. The first-line treatment has been carboplatin and paclitaxel for many years and this provides a progression-free survival of about 13 months and an overall survival of just over three years. We have used endocrine therapy with response rates of up to 55% have been reported. When patients are ER/PR positive, Tamoxifen or Megace have been used and also more recently, aromatase inhibitors. Second-line chemotherapy, however, only has an overall response rate of between 0 and 27%. If patients have localised disease, then we do consider surgery or chemoradiation. Recently, there's been an evolution of immunotherapy and biomarker-directed systemic therapy. But outcomes are still poor in those who recur. Therefore, reducing the risk in the earlier stage of the disease is very important. Risk stratification in early stage disease

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Endometrial cancer: integrating molecular insights into personalized care

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